瑞芬太尼复合丙泊酚静脉泵注维持对腹腔镜胆囊切除术患者的影响OA
The Effect of Remifentanil Combined with Propofol Intravenous Pump Maintenance on Patients Undergoing Laparoscopic Cholecystectomy
目的:探讨在腹腔镜胆囊切除术中,瑞芬太尼复合丙泊酚静脉泵注维持的应用效果.方法:随机将白银市中西医结合医院 2023 年 1 月—2025 年 2 月收治的 121 例行腹腔镜胆囊切除术患者分为两组,对照组(60 例)采用 3～4 mg/(kg·h)丙泊酚静脉泵注维持麻醉,研究组(61 例)在对照组基础上联用 8～10 μg/(kg·h)瑞芬太尼静脉泵注维持麻醉.对比两组围手术期生命体征指标和氧化应激指标,术后疼痛和镇静评分,苏醒质量及不良反应发生情况.结果:气腹建立后 10 min,两组SBP、DBP、HR、SpO2 较麻醉诱导前 5 min和麻醉诱导后 5 min下降,但研究组高于对照组(P<0.05).拔管后15 min,两组SBP、DBP、HR、SpO2 较气腹建立后 10 min时上升,且研究组高于对照组(P<0.05).拔管后 15 min,两组去甲肾上腺素(NE)、皮质醇(Cor)水平较气腹建立后 10 min上升,研究组低于对照组(P<0.05).术后 6、12 h,两组数字分级评分法(NRS)评分较术后 2 h升高,但研究组低于对照组(P<0.05).术后 2 h,研究组镇静躁动评分[肌肉活动评分法(motor activity assessment scale,MAAS)评分]低于对照组,Ramsay镇静评分高于对照组(P<0.05).研究组术后 48 h内镇痛药物追加用量和不良反应发生率低于对照组,自主呼吸恢复时间、呼之睁眼时间、拔管时间早于对照组(P<0.05).结论:在腹腔镜胆囊切除术中,瑞芬太尼复合丙泊酚静脉泵注维持能够更好地实现患者镇静镇痛,并改善围手术期生命体征和氧化应激指标,减少不良反应发生,麻醉实用性和安全性更高.
Objective:To explore the application effect of Remifentanil combined with Propofol intravenous pump maintenance in laparoscopic cholecystectomy.Method:A total of 121 patients who underwent laparoscopic cholecystectomy in Baiyin Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to February 2025 were randomly divided into two groups.The control group(60 cases)was treated with intravenous pumping of Propofol 3-4 mg/(kg·h)to maintain anesthesia,and the study group(61 cases)was treated with intravenous pumping of Remifentanil 8-10 μg/(kg·h)on the basis of the control group.The perioperative vital signs and oxidative stress indicators,postoperative pain and sedation scores,recovery quality and the occurrence of adverse reactions were compared between the two groups.Result:Ten minutes after the establishment of pneumoperitoneum,SBP,DBP,HR and SpO2 in both groups decreased compared with those 5 minutes before anesthesia induction and 5 minutes after anesthesia induction,but those in the study group were higher than those in the control group(P<0.05).15 minutes after extubation,SBP,DBP,HR and SpO2 in both groups increased compared with those 10 minutes after the establishment of pneumoperitoneum,and those in the study group were higher than those in the control group(P<0.05).15 minutes after extubation,the levels of norepinephrine(NE)and cortisol(Cor)in both groups increased compared with those 10 minutes after the establishment of pneumoperitoneum,and those in the study group were lower than those in the control group(P<0.05).At 6 and 12 hours after the operation,the numerical rating scale(NRS)scores of both groups were higher than those at 2 hours after the operation,but the scores of the study group were lower than those of the control group(P<0.05).2 hours after the operation,the sedation-restlessness score[motor activity assessment scale(MAAS)score]of the study group was lower than that of the control group,and the Ramsay sedation score was higher than that of the control group(P<0.05).The additional dosage of analgesic drugs within 48 hours after the operation and the incidence of adverse reactions in the study group were lower than those in the control group,and the recovery time of spontaneous breathing,the time to open eyes upon call,and the extubation time were earlier than those in the control group(P<0.05).Conclusion:In laparoscopic cholecystectomy,Remifentanil combined with Propofol intravenous pump maintenance can better achieve sedation and analgesia,improve perioperative vital signs and oxidative stress indicators,reduce the occurrence of adverse reactions,and has higher anesthesia practicality and safety.
闫永宏;汪柯柯;顾中华
白银市中西医结合医院麻醉科 甘肃 白银 730900白银市中西医结合医院麻醉科 甘肃 白银 730900白银市中西医结合医院普外科 甘肃 白银 730900
腹腔镜胆囊切除术瑞芬太尼丙泊酚
Laparoscopic cholecystectomy surgeryRemifentanilPropofol
《中国医学创新》 2026 (9)
40-45,6
白银市科技计划项目(2023-1-47Y)
评论